Folic acid is so crucial to reducing the risk of neural tube birth defects that, in 1998, Canada mandated that all flour, enriched pasta, and cornmeal be fortified with it. And it appears that folic acid’s benefits to the developing foetus may not end there: a study analyzing data from before and after Canada’s fortification mandate found a correlation between folic acid and a reduced risk of congenital heart defects (CHDs). Published in Circulation, the study included data on 5,901,701 live and stillborn births delivered at 20 weeks or later in Canada from 1990 to 2011. The researchers found 66,980 occurrences of non-chromosomal CHDs during this time. After controlling for other changes over the study period, including average maternal age and rates of prepregnancy diabetes, preterm preeclampsia, multiple births, and pregnancy terminations, they found that the folic acid fortification programme was associated with:

• an 11% reduction in rates of non-chromosomal CHDs overall;
• a 27% reduction in conotruncal defects, which are abnormalities that affect both of the blood vessels leaving the heart (the aorta and the pulmonary artery);
• a 23% percent reduction in coarctation of the aorta, which is a narrowing of the aorta (the major artery carrying blood to the body);
• a 15% reduction in ventricular septal defects and an 18% reduction in atrial septal defects, which are holes in the walls separating heart chambers;
• and, no changes in rates of severe non-conotruncal heart defects and other heart or circulatory system abnormalities.

This study drives home the importance of getting enough folic acid during pregnancy. In addition to fortified foods, leafy greens, citrus fruits, avocados, beetroot, beans, and whole grains are sources of folic acid. Also, during pregnancy, a prenatal multivitamin with folic acid is usually recommended, so talk with your doctor if you are considering adding one.

Source: Circulation